Provider Demographics
NPI:1730824905
Name:UPADHYAY, NEIL SATISH (DPM)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:SATISH
Last Name:UPADHYAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7925 JEWELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-7541
Mailing Address - Country:US
Mailing Address - Phone:561-324-0461
Mailing Address - Fax:
Practice Address - Street 1:3200 HIGHLANDS PKWY SE STE 100
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5192
Practice Address - Country:US
Practice Address - Phone:770-319-5502
Practice Address - Fax:404-481-4452
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GAPOD001556213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program